Organizational Change Form

Organizational changes come in many shapes and sizes…from changes in supervisors to a complete reorganization in a department. The Organizational Change Form keeps the HR staff informed about departmental organizational needs, and allows them to update Banner and other systems.

This form should be completed:

By the supervisor/manager requesting the organizational change;

For employees in the area who have been affected by reorganization.

Submit this form and any appropriate documents to the Office of Human Resources at least two weeks prior to the effective date of change. HR will distribute the form for electronic approvals.

Submission of this form to HR assumes that the supervisor/manager and the Cabinet VP have agreed to the changes.

Employee / Department Information

Department:*

Cabinet Member:*

Employee's Name:*

FirstLast

Employee's Position Number:

Supervisor's Name:*

FirstLast

Reviewer's Name:*

FirstLast

Nature of the Change

Title Change

Title Change

New Working Title:

Supervisor Change:

Supervisor Change

New Supervisor Name:

FirstLast

Department Transfer:

Department Transfer

New Department:

Location Change:

Where a department or individual moves to (location / building & room #)

Compensation Actions:

Name(s) of employee(s) this person directly supervises only if they are impacted by this change: